Chorionic gonadotropin (CG) is a hormone that is produced by chorionic tissues immediately after implantation. Normally, it is present in the body only during pregnancy. Thanks to the achievements of medicine, this hormone is created artificially for the purpose of treating anovulation (a violation of the cycle, which makes it difficult to conceive naturally). Why and when are shown injections of hCG? What is the result of such therapy?
The mechanism of action of the injection of hCG
Chorionic gonadotropin is involved in the synthesis of sex hormones, has a positive effect on the maturation of eggs and a key event of the cycle - ovulation. It is used to stimulate the output of the oocyte, if for any reason this process does not occur independently and anovulatory cycles are observed (rapid tests for ovulation are negative).
Injection of hCG promotes ovulation, supports the work of the corpus luteum (temporary endocrine gland, which produces a hormone progesterone up to 16 weeks). In the first phase of the cycle, the follicle growth is stimulated under the influence of an estrogen substitute. When an ultrasound shows its maturation up to 2.5 cm in diameter, a chorionic gonadotropin injection is given. It takes into account that two days have passed since the last dose of Klostilbegit stimulator.
Ovulation happens 1-1.5 days after the administration of a hormonal substance. Within two days, there is a favorable period for fertilization that future parents should take advantage of. About the moment of ovulation, the woman will be prompted by her own feelings, as well as a special pharmacy test. It will show a reliable result before the injection of hCG, after it the follicle rupture can be seen by ultrasound.
CG injection may be needed for:
- stimulation of follicle rupture after treatment with Klostilbegit,
- maintaining the life of the corpus luteum,
- support pregnancy until the 16th week until the placenta is formed.
For the production of hCG preparations, proteins extracted from the urine of expectant mothers are used. In Russia, you can buy domestic and imported funds. They are appointed by doctors strictly according to indications. Self-medication can lead to hormonal disorder in the female body.
The dosage of CG preparations is selected individually, is 500, 1000, 1500, 5000, 10000 units. The following drugs are distinguished by titles: Pregnil, Choragon, Eco-Stimulin, chorionic gonadotropin. The cost of drugs depends on the manufacturer, pharmacy markups, dosage. An average injection of HCG will cost 1500 rubles.
In what cases is appointed?
Indications for injection of hCG medications:
- anovulatory cycles
- supporting the functioning of the corpus luteum,
- preparation for IVF at the stage of stimulation of ovulation,
- the threat of miscarriage in the early stages,
- habitual miscarriage in history
- menstrual irregularities.
Contraindications for HCG injection
When prescribing the drug, the doctor takes into account the age, state of health of the patient and the available contraindications:
- individual intolerance to the components of the tool,
- a number of diseases of the endocrine system, including the thyroid gland,
- early menopause
- oncopathology of the female reproductive system,
- tendency to thrombosis,
- lactation period
- adhesions in the pelvis.
In the presence of contraindications or on prescription, ovulation stimulation is performed without the administration of hCG, only through the introduction of clostilbegit. In this case, the follicle bursts on its own after maturation, as shown by the ovulation test. However, this does not always happen.
CG preparations are produced in the form of a ready solution or components for its preparation (powder and water). The physician should be trusted with the injection, since the place of intramuscular injection is the abdominal region. The dosage and time of administration are selected by an obstetrician-gynecologist. Most often used drugs dosages of 1000, 5000, 10000 units.
Preparation for the procedure
After the introduction of the hormone, the probability of pregnancy is very high, so it’s worth preparing in advance for the procedure. For this, it is important to get rid of bad habits and stresses, to establish a healthy lifestyle. An important role is played by the normalization of weight - its excess and deficiency can become an obstacle to the successful conception and bearing. In parallel, it is recommended:
- testing of the hCG drug for individual intolerance,
- testing for immunological compatibility with a partner, STI,
- examination by a therapist,
- Ultrasound of the uterus and appendages,
- pipe patency diagnostics,
- a course of hormonal therapy and hysteroscopy (if necessary),
- checking the quality of the sperm of the future father (spermogram).
After collecting anamnesis, the doctor determines the type of drug, prescribes its dosage and time of administration. On the specified day, the patient comes to the medical office for the injection.
How is the required dose selected?
The dosage is determined depending on the goal that the doctor sets. The hCG injection during ovulation stimulation is done with a dosage of 5,000 units after the detection of a dominant follicle. Superovulation before IVF is called with a drug dosage of 10,000. The process of ovulation is monitored by ultrasound. For maintenance therapy, dosages of 500, 2000 IU are used. Injections are shown at 3, 6, 9 days after ovulation.
With the threat of miscarriage in the early stages are convinced in the absence of ectopic pregnancy. Initially, the drug is administered at a dosage of 10,000 IU, and then weekly at 5,000. Therapy can last up to 14 weeks. In parallel, Duphaston or Utrogestan are shown to maintain the desired level of progesterone.
How and when is an injection given?
The drug is injected intramuscularly with an insulin syringe with a thin needle. Where to do the injection, the doctor determines. To stimulate ovulation, it is placed in the stomach, for which distance 2 fingers from the navel sideways recedes. Place is treated with alcohol. Then pinch the skin fold and insert the needle of the syringe. The alternative for injections is the area of the buttocks.
When ovulation is stimulated, gonadotropin will perform its functions if an injection is given 1-1.5 days before the intended ovulation. Control this process by ultrasound, put an injection at 10-14 days after the start of the menstrual cycle. The rupture of the follicle takes place exactly at the period when the injection is given. The subsequent cycles of the injection is not affected.
To maintain the function of the corpus luteum, supportive therapy of hCG may be prescribed to pregnant women. Usually the injections are placed 3, 6, 9 days after the rupture of the follicle.
What side effects can be?
Side effects after the injection of hCG, which are observed in violation of the introduction process and overdose:
- late ovulation, which, with an unprepared endometrium, leads to abortion,
- accumulation of fluid in the abdominal cavity
- allergic manifestations of the skin, respiratory organs,
- fast fatiguability.
The most serious complication is ovarian hyperstimulation syndrome, in which many follicles simultaneously grow. They do not burst, but develop into cysts, which is dangerous for health and leads to heart and respiratory failure, and other serious consequences. Not recommended joint administration of the drug with glucocorticosteroids in high dosages.
If pregnancy has not occurred as a result of therapy, you need to tune in for further treatment. Perhaps the long-awaited conception will happen naturally in 2-3 months after hormonal intervention. At the disposal of modern fertility enough technology that will help a woman become a mother.
It is worth knowing that not all ovulation occurs after the injection of hCG. In some, the dominant follicle continues to grow until it turns into a cyst. It is also understood that this is not a method of treating anovulation. An injection can simply help the body grow a dominant follicle and release it. The stimulation performed will not be able to restore ovulation in other menstrual cycles.
It is also important to understand that the diagnosis of anovulation should be made on ultrasound. They begin to talk about him when a woman has not had an egg cell for several cycles in a row. You can not assign an injection of hCG, based only on the data graphs of basal temperature.
In addition, before stimulation, it is desirable to check the hormones. Sometimes it is enough to undergo a course of treatment in order to restore reproductive function. They check female and male hormones, evaluate the work of the thyroid gland. If violations were identified, they must be corrected. After all, with serious problems, even the use of hormone injections may be ineffective.
It is important to understand that any intervention in the natural processes taking place in the body should be carried out under the supervision of a physician. It is necessary that only the treating gynecologist prescribed an injection of hCG for ovulation. He should also monitor the patient’s condition and monitor the body’s response to the indicated drug. A specialist before the appointment of stimulation should evaluate the dynamics of growth of follicles, endometrium, predict the onset of ovulation.
The process of carrying out the procedure and control will depend on whether you are just given an injection of hCG, or whether the doctor advises you to use drugs that promote follicle growth. It can be such means as "Puregon", "Menogon", "Klostilbegit".
Regardless of how it was possible to achieve growth and maturation of the follicles, prescribe hCG (injection). Instructions for such drugs allows you to know that ovulation should occur no later than 36 hours after injection. The doctor may prescribe the drug "Horagon", "Pregnil", "Gonacor", "Profazi", in pharmacies you can also find the usual ampoules "Gonadtropin chorionic." The dosage (as a rule, it is 5 or 10 thousand. IU) also selects a gynecologist.
After the doctor saw a ripe follicle on the ultrasound and prescribed an injection of the hCG drug, it must be confirmed that he was able to burst and the egg came out. Gynecologists recommend having sexual intercourse every other day on condition of natural conception. If artificial insemination is needed, it is usually done daily. It is advisable to try to conceive a child in the period after the injection of hCG and until the yellow body becomes visible on the ultrasound. It indicates that ovulation has passed.
After that, additional stimulation of the corpus luteum is appointed. If the egg is fertilized and the pregnancy comes, progesterone drugs will help support its development.
They should not be prescribed on the averaged 14–16 day of the cycle, as many domestic gynecologists recommend, but after the onset of ovulation is confirmed. As such supportive drugs prescribed "Utrozhestan" or "Duphaston".
How to do injections
All who are prescribed an injection of hCG are interested in how and when they should be done. Of course, you can contact the clinic of reproductive medicine (if the stimulation is done in the IVF protocol) or the gynecology treatment room.
But many still inject themselves at home. These drugs, regardless of trade name, are available in dry form. They must be diluted with a special solvent, and then injected with intramuscular injections of hCG. Reviews of women who stimulate ovulation using these tools indicate that this procedure is unpleasant, but tolerable. Injections are well tolerated, they are virtually painless.
The drug can be injected into the gluteus or in the front of the thigh. It is done once before ovulation. But in some cases (as a rule, with artificial insemination), the injections are repeated several times to support the work of the corpus luteum.
Do not self-prescribe a hormone without the advice of a doctor. Also, it is not necessary to prick it, if the mature follicle is not visualized on the ultrasound. After all, ovulation after the injection of HCG can occur only when the body is ready for it. The hormone is designed to stimulate this process.
Usually for the first time the doctor recommends using 5 thousand. If this dosage did not lead to rupture of the follicle, then in the next cycle the gynecologist may recommend already 10 thousand units.
If ovulation has occurred, and this has been confirmed by an ultrasound, the doctor may prescribe a stimulation of the function of the corpus luteum. For these purposes, injections are prescribed for 3-6-9 days after the egg is released. Used in these cases, hCG with a dosage of 1.5 or 5 thousand units.
With habitual miscarriage, women are given injections of the indicated drug at the earliest possible time and continue this therapy for up to 14 weeks. Begin treatment with an injection of 10 thousand. - this dosage is administered on the first day of therapy. In the future, support for pregnancy is done as follows: twice a week, 5,000 IU are administered.
Possible side effects and contraindications
In appointing injections of hCG, it is important to ensure that ovulation occurs. In some cases, it happens that the effect of ovarian hyperstimulation occurs. At the same time, the follicle does not burst, but develops into a cyst. Other side effects are also possible:
In addition, some complain about the pain of the injection site, the appearance of a rash on this site, breast tenderness, the occurrence of fever and generalized rash. But, despite the possible complications, many agree to such injections. After all, there is a high probability that a pregnancy will occur after the injection of hCG.
It is not prescribed for hypersensitivity to human gonadotropin or to other components of the remedy, and in those cases if there are tumors whose growth depends on hormones. It may be ovarian, uterine or mammary gland cancer in women. Even if the diagnosis has not yet been established, but the doctor suspects oncology, then hCG injections should be abandoned.
Scope of application
Regardless of the trade name, all hCG preparations act according to a single principle. They stimulate the production of sex hormones. It is worth noting that hCG is prescribed not only for the treatment of anovulation.
It is also recommended to use for chronic miscarriage, the threat of miscarriage and ovarian dysfunction. In some cases, this drug is prescribed and men. As a rule, it is used to correct genetic disorders. It is prescribed for delayed puberty, the cause of which was the lack of gonadotropic function of the pituitary gland. It is also used in cryptorchidism. The exception is when the disease is caused by an incorrect position of the testicles or a hernia in the groin.
What is an HCG injection for?
According to the latest statistics, only 50% of women can become pregnant in the first three months after the start of planning. About 75% percent get pregnant for six months and as many as 90% of women get the cherished strips within a year. As you can see, if a woman really wants to get pregnant in the near future, then she needs to stimulate the process of ovulation.
So, in order for a pregnancy to occur, three things must happen in the body:
- Fastening the ovum.
As soon as the third stage occurs, the body immediately begins to produce the hCG-pregnancy hormone. If the pregnancy does not occur, the doctor prescribes a hCG injection to the woman. When does a doctor approve of stimulating ovulation with this injection?
- The woman has rare ovulation,
- Within 12 months a couple can not get pregnant on their own,
- Over the age of 35, if the pregnancy has not occurred within six months.
In order to accelerate the growth of follicles and the release of an egg from them, an injection of hCG is prescribed.
When should an HCG injection be given?
Assign this injection if ovulation has not occurred. From the first phase of the cycle, the doctor monitors the growth of follicles and simultaneously prescribes estrogens to the woman for additional stimulation. After, when the follicle has reached a size of 25 mm in diameter, the doctor prescribes to introduce a drug containing hCG. After the introduction of the drug ovulation will come in 2-3 days. The best time for conception comes 2-3 days after the injection.
This injection should be given at the following points in the body:
- Lack of luteinizing hormones for which the hypothalamus and pituitary gland are responsible.
- When polycystic ovaries form anovulation.
- Hyperandrogenism is a phenomenon in which a large number of male hormones develop in the female body, and female, as a result, is lacking.
- Syndrome of early ovarian exhaustion, in which follicle maturation is not observed.
- Another reason why an HCG injection should be given is preparation for IVF.
Should a woman stimulate the process of ovulation, only a female doctor will determine after a series of specific studies.
Do I need preliminary preparation before the injection?
It is important to understand that after the injection the woman is likely to become pregnant. Therefore, it will be wise to begin training in a few months. Pay attention to your diet. It should be balanced and rich in vitamins. In addition, a woman should get enough sleep and take enough folic acid.
Immediately before the injection of HCG, you need to undergo some tests.
- Check for individual intolerance to this drug,
- get an extract from a therapist that a woman can bear a child,
- make blood tests for sex hormones,
- advance to a course of estrogen stimulation,
- be tested for sexually transmitted diseases,
- vaginal smear on the purity and availability of STDs,
- diagnose the fallopian tubes and make sure that they are passable,
- go through a hysteroscope study,
- to undergo an ultrasound examination of the female organs and mammary glands,
- make sure there are no cancers,
- be tested for compatibility of sexual partners,
- and most importantly, partnering for sperm quality. After all, if a man is barren, then you should not waste time on stimulating ovulation.
After all these tests, tests and tests, the doctor prescribes a drug that is right for you. Injection of hCG has a different dosage.
How to put a hCG injection?
This injection put in the buttock. Depending on the indicators of research and various individual nuances, the doctor will choose the dosage of the injection. What will affect the appointment?
- Woman's age
- its weight (the bigger it is, the weaker the ovaries react to the drug),
- cause of infertility.
After the appointment of the dose put an injection, which produce once a day. The following describes the differences between the two dosages of the hCG preparation.
- Dosage 5000mE. This drug is prescribed to women with a normal body weight, in which ovulation does not occur. The drug affects the luteal hormone and encourages its production. Also this injection will be applied if the woman has a deficiency of the yellow body. To stimulate the injection, 5,000 IU each are given on the third, sixth and ninth day after the intended ovulation.
- A dosage of 10000mE is used for the development of superovulation. Usually this dose is prescribed to women with increased body mass or ovaries depleted.
Depending on the dosage, ovulation will occur either after 42 hours or 48 hours. Therefore, sexual intercourse should be carried out starting from 24 hours and ending with 36 hours. Usually after an injection it is recommended to have sex every other day and two days in a row.
Contraindications and side effects
As with any drug, this injection has contraindications and undesirable effects. All because it is in any case an intervention in the human body.
- Cancer in the ovaries,
- Menopause in the early stages
- Fallopian tube obstruction,
- Malfunctions of the thyroid gland,
- Predisposition to thrombosis,
- Allergic reactions to the composition of the drug.
If there is at least one contraindication from the list, stimulation of ovulation by hCG injection is prohibited.
After the woman still put this injection, she may have a number of side effects.
- The most severe side effect is ovarian hyperstimulation. According to estimates, this phenomenon is found in women in the range from 1 to 14%. With ovulation, one egg is formed. When they are over-stimulated, up to 20 pieces can form! And this, in turn, will lead to the following problems:
- Accumulation of fluid in the lungs and abdomen,
- Nausea with vomiting
In addition to all this, multiple pregnancies can occur. To avoid such problems, strictly follow the recommendations of the doctor and do not put yourself a shot without a doctor.
The positive effect of the injection
The most positive effect of hCG injection is ovulation and the onset of pregnancy. If ovulation comes within three days, then pregnancy may occur as early as a week after ovulation itself. It is usually recommended to start testing 1.5-2 weeks after the procedure.
If the woman is still pregnant, then in some cases she is given another injection of hCG. What for? To keep an existing pregnancy. After all, this hormone has a positive effect to eliminate the risk of miscarriage.
Where to buy? The cost of the drug?
This solution can be purchased at a regular pharmacy. Usually it is released strictly according to the recipe with the specified dosage. After all, if it is pricked without a properly selected dosage, or even without an appointment, then the consequences can be very serious. A woman can get an ectopic pregnancy, or kill her hormones so much that she can no longer have children.
The price depends on the pharmacy, brand and manufacturer of the drug. The average price in Russia is 1000-1500 rubles per dose of hCG.
So, hCG injection is a great way to stimulate ovulation, and get a quick pregnancy. However, it is important to remember that without prior testing and consulting a gynecologist this drug can cause irreparable harm.
Providing a drug effect on the maturation of the egg is a process that requires special training, functional support and monitoring, compliance with precautionary measures. Drug stimulation of ovulation: the choice of drugs, their dosage and scheme of use - the procedure is exclusively responsible and should be performed only under the direct supervision of the attending physician.
The protocol of the procedure of drug stimulation of ovulation is strictly individual for each pair and includes:
- a schedule showing the exact time of individual examinations and analyzes,
- the choice of specific drugs, their dosage, scheme and time of use,
- preferred method of fertilization
- schedule of ultrasound monitoring of the development of the follicle and the first weeks of embryonic development.
Stimulation of ovulation has a very powerful effect on the ovaries, it can be used no more than 6 times during the reproductive period of a woman’s life, therefore, is appointed only with her long absence.
For women under the age of 35, such “help” is resorted to if, in the absence of obvious diseases that prevent pregnancy and with regular unprotected sex for more than one year, the couple fail to conceive the fetus in a natural way. After 35, such a period of unsuccessful attempts, is reduced to six months.
Stimulation will not give a positive result if, in choosing the method of recovery, the doctor did not accurately establish the reason why there is no maturation of the egg. Throughout the above time, you should carefully consider the measurement and scheduling of basal temperature. It is recommended several times to pass tests to check hormonal levels. It is possible that with the restoration of the normal ratio of estrogen, androgens and progesterone, normalization of the level of thyroid hormones (T3 and T4) and the pituitary gland (TSH and prolactin), the ovulatory cycle will also fully recover.
Absolutely justified and the passage of the partner sperm. Even if, prior to these attempts, he already had his own children or his previous partners were getting pregnant, anyway, you should check the "readiness" of sperm at the moment.
The basis for auxiliary stimulation of the ovaries is the result of ultrasound monitoring, confirming the violation of the development of follicles and corpus luteum. This observation is carried out according to the following schedule - the first study is conducted on the 8-10 day after the end of menstruation, then every 2-3 days until the next critical days.
Stages of stimulation
The specific date and duration of auxiliary stimulation of ovarian work is determined during the preparation of an individual protocol. Observation with the help of ultrasound is carried out starting from the 2nd day after taking the first hormonal drug, and is repeated every 2-3 days, until the positive dynamics of the embryo development in the first weeks of pregnancy.
If during the initial monitoring it was found that the dominant follicle develops independently and normally to the desired size, but cannot break apart, but regresses or turns into a cyst, then in such cases only the injection of hCG is used, which serves as an artificial stimulus for rupture. If ovulation does not occur for other reasons, then one introduction of human chorionic gonadotropin is indispensable and the following step-by-step actions are performed.
The maturation of the follicle and drugs clomiphene
Klostilbegit tablets - the most common means on the basis of clomiphene, which enhances the production of FSH and LH and, thereby, stimulates the development of follicles.
The classic scheme is the use of Klostilbegit tablets from the 5th to the 9th day of the menstrual cycle, with an obligatory ultrasound on the 7th and 9th day and the subsequent hCG-stimulating injection of Pregnila, Horagon or Profazi. The time interval for taking pills can vary from 2 (3) to 7 (10) days, if the doctor decides it is necessary to take advantage of more benign varieties of chorionic gonadotropin - menopausal or laboratory recombinant.
To maintain hormonal balance, drugs containing estrogen are prescribed in parallel with clomiphen tablets, for example, Proginov tablets. Taking these drugs starts at the same time. Estrogen withdrawal occurs on day 21 of the menstrual cycle.
Rejection of the use of clomiphen-containing drugs and a fundamental review of the tactics of infertility treatment (for example, replacement with Gonal, Puregon, Menogon) occurs only after three unsuccessful conception attempts.
Oocyte maturation and hCG injection
When the ultrasound examination shows that the selected one or several follicles have grown in size to 17-18 mm, an injection of hCG should be done, which will contribute to the final maturation of oocytes (immature oocytes), breaking the walls of the follicle and the release of the mature ovum from the ovarian body.
After the injection of gonadotropic hormone, the ovaries increase in size and cause a feeling of discomfort in the lower abdomen. However, this condition is not a 100% guarantee of the rupture of the follicle, the release of the egg, and requires confirmation by ultrasound.
The onset of ovulation and fertilization
Regardless of the dosage of the injection, 5000 or 10000, the process of maturation and release of the egg ends 42-48 hours after injection.
If the protocol provides for artificial insemination outside the female body, the puncture of the follicles is prescribed for an interval between 24 and 36 hours after the injection of chorionic gonadotropin.
In the case of fertilization of the egg naturally, sexual intercourse should be held daily - one day before, on the day of the hCG injection and for the next 2 days.
It is important - the crucial point is the exact observance of the estimated time of introduction of human chorionic gonadotropin, and not how many units of the hormone will be introduced.
Embryo development and progesterone
Immediately after ovulation for additional support, insurance and relief of the work of the corpus luteum, estrogen administration is canceled, progesterone-based pills are prescribed - Duphaston or Utrogestan. Progesterone helps to prepare the inner layer of the uterus for implantation (attachment) of a fertilized egg and helps maintain pregnancy in the first weeks of the embryo. Supportive use of progestin drugs continues until the full development of the placenta.
Klostilbegit tablets are taken one at a time once a day.
The hCG injection can be performed only once per entire treatment cycle. The choice of drug and its dosage remains exclusively in the competence of the doctor. As a rule, a gonadotropin injection is given once in a dosage of 5,000 or 10,000 IU. The drug is a dry powder, which immediately before the injection must be diluted with the solvent attached to it. Intramuscular injection is performed by a woman on her own and is painless. It is important to closely monitor compliance with the dosage, since exceeding it will lead to overstimulation, egg death and ovarian depletion, and an understatement will not give the desired result.
There is also a practice when the protocol for the introduction of gonadotropic hormone is amended and injections are performed several times in one cycle. If the follicles have reached the desired size (20-25 mm), and ovulation has not occurred, then a second injection of hCG can be prescribed to re-stimulate the rupture of the walls and prevent the formation of follicular cysts. Another additional shot is possible to help the yellow body. The dosage of these injections is small (300 - 1500 IU). How many units will be specifically entered - the decision is made by the doctor.
Overdose during stimulation - an excess of gonadotropin, can cause ovarian hyperstimulation syndrome or end their rupture. Using the drug more than 6 times threatens ovarian depletion and early menopause.
Hcg injection during pregnancy
During pregnancy, monitoring of gonadotropin levels over time is necessary: after conception, its level doubles every 2-3 days, reaches its maximum performance by the end of the first trimester, then decreases slightly and should remain unchanged until delivery. If such monitoring shows a decrease in concentration or complete cessation of the production of human chorionic gonadotropin, then in order to preserve pregnancy, prevent fetal death or threaten miscarriage, hCG shots are prescribed that will maintain gonadotropin levels within normal limits depending on the duration of pregnancy. Typically, the dosage ranges from 1000 to 3000 IU.
Under what circumstances need hkch injection?
Stimulation of ovulation and fertilization with clostilbegit and the injection of hcch is done under certain indications, which are determined by the gynecologist during the examination. In general, chorionic gonadotropin injections are given to women in the following circumstances:
- If a woman is younger than 35 years old (it is difficult to become pregnant at a more mature age, especially if there are diseases or injuries of the fallopian tubes),
- If the father of the unborn child has a good spermogram (ovulation will occur faster and the fetus will develop immediately after the injection),
- If there is no long-term and ineffective treatment of infertility under the IVF program (in this case, the conception rate is very low),
- The woman has polycystic disease, also anovulation, during which the egg does not mature in the body and is therefore not fertilized,
- If there are no pathologies of the uterus and fallopian tubes (the egg is fertilized more quickly after the hgch injection, and the woman has a chance of becoming pregnant)
- If there is no oncology, venereal and infectious diseases of the reproductive system,
- If there is a hormonal failure (the woman does not have enough progesterone, which is responsible for ovulation, the menstrual cycle and pregnancy).
Please note that the use of clostilbegit and other drugs without consultation with the gynecologist is not recommended. After all, there is a large selection of drugs containing a certain amount of hgch, and the selection of medicines must be made taking into account the individual characteristics of the organism.
Ovulation in women occurs 2-3 days after the injection of hcch. These days will be considered more successful and favorable for conception. If, after an injection, you cannot become pregnant during ovulation, it is recommended to do VMI or IVF. Usually this procedure is required for women after 30 years, since reproductive abilities after this age decrease.
To remedy the situation, there are different methods of stimulating ovulation. Typically, a gynecologist prescribes: Duphaston, Utrozhestan and Iprozhin, which help to assimilate chorionic gonadotropin.
Order of stimulation
In order for an injection to stimulate fertilization and ovulation to work effectively, it is necessary to familiarize yourself with the procedure of the procedure. In general, the stimulation of ovulation in women occurs in this order:
- If there are no contraindications and serious diseases, the gynecologist prescribes the drug and consults on how to put it, and what dose will be acceptable.
- After that, the woman must enter into the stomach a drug that will help open the egg during ovulation, so that the conception will be successful.
- After the injection of an hcc 10,000, ovulation should occur within 2–3 days, after which the woman can carry out conception, since the egg must open.
- If, after the injection, ovulation has not occurred or it is impossible to get pregnant, you need to contact a gynecologist or perform IVF, in which you artificially fertilize an egg.
Please note that the injection of 5000 xg has an effect through time, that is, you can conceive a child 1-2 days after ovulation occurs. Attempts are recommended to repeat several times, especially if there are signs of ovulation after the injection of hcch. Indeed, during the onset of ovulation, the egg may not fully open, so you can fix it if you have intercourse several times in a row. After examining the gonadotropin regimen and how the stimulation takes place, a woman can understand how to properly inject the hGH injection and that will contribute to the onset of ovulation after stabilization with clostilbegit.
Contraindications and possible complications
Injection of hgch to stimulate ovulation can be done only in those cases if there are no following contraindications:
- Malignant tumors and cancers of the female reproductive system,
- Obstruction of the fallopian tubes and inflammatory processes,
- Thrombosis and obstruction of blood vessels,
- Allergic reaction to the components of the drug.
After the injection of pregnila is injected, ovulation is stimulated, but not always.
Могут возникать побочные действия, а именно:
- Nausea and vomiting.
- Метеоризм и диарея.
- Скопление ненужной жидкости в брюшной полости.
- Дисфункция матки и яичников и женщин.
Показания к инъекции ХГЧ
Stimulation of maturation and exit of the follicle-ready egg from fertilization is not shown to all women who have problems with conception. This option of dealing with infertility is suitable for those who have a dominant follicle in the ovaries, but for some reason the egg inside it, either goes out of maturity or does not systematically mature at all.
The cause of this pathological condition can be:
- insufficiency on the part of the pituitary or hypothalamus, as a result of which a deficiency of luteinizing or follicle-stimulating hormones develops, which are responsible for the usefulness of the ovulatory processes,
- PCOS is a polycystic ovary syndrome, against the background of which regular anovulatory cycles are observed,
- hyperandrogenism - a disease accompanied by increased synthesis of androgens or male sex hormones with a pronounced deficit of female hormones,
- primary degree ovarian insufficiency or syndrome of premature ovarian depletion, which is accompanied by impaired follicle maturation processes.
In addition to the above indications for the stimulation of ovulation, there is another one - in vitro fertilization.
In any case, the need for artificial stimulation of ovulation is determined by the doctor. Only a specialist, based on the results of a number of studies, can correctly diagnose and prescribe the appropriate treatment.
The injection of hCG to stimulate ovulation is one of the main options for combating the impossibility of natural conception due to the lack of a ripe egg cell. In turn, the need for the introduction of human chorionic gonadotropin is due to the following factors:
- insufficiency of the corpus luteum,
- systematic repetitive anovulation cycles,
- with regular miscarriages,
- in the case of the threat of spontaneous abortion.
How does he work?
Stimulation of ovulation can be carried out Klostilbegitom or injection of hCG. Both work according to an identical principle: due to their unique composition, namely, the presence of follicle-stimulating and luteinizing hormones, the maturation and release of the egg-cell ready for fertilization is stimulated. This is a kind of replacement procedure.
The use of injections of hCG and other drugs of similar action also helps to activate the work of the corpus luteum. And if Klostilbegit is an oral medication, the injections of hCG are administered intramuscularly, which causes the active substances to immediately enter from the muscles into the bloodstream.
With regard to the onset of ovulation, then after the injection it occurs in 24-48 hours, which is also confirmed during the ultrasound.
Basic principles of the procedure
Before stimulating the maturation and release of the egg from the follicle, using hormonal preparations or gonadotropin injections, you must undergo a series of procedures:
- In clinical studies, determine whether there are any individual intolerances to using a particular drug that will be used for the stimulating procedure.
- Get a conclusion from a therapist about the possibility of carrying a child.
- Complete a series of clinical studies: blood for FGS, LH and prolactin. It is also worth assessing the hormonal background and the work of the reproductive system as a whole. To do this, you can also pass the appropriate tests and undergo ultrasound.
- Next, you need to make sure that there are no contraindications to the use of a drug to stimulate ovulation. And, if the doctor sees fit, then offers to undergo a course of preliminary estrogen therapy.
- After that, you need to check the viability of male germ cells. For this partner must make a spermogram.
- The next step will be testing - detailed ELISA, HIV, syphilis, hepatitis B and C.
- General examination of smears for the presence of gynecological diseases and any other pathological abnormalities in the reproductive system.
Some women additionally check the patency of the fallopian tubes, the functionality of the endometrium, ovaries and mammary glands. But this is all purely individual and / or prescribed by a doctor.
The very same stimulation procedure is carried out as follows: having determined the specific date and duration of additional stimulation of the ovaries, the doctor prescribes the day of the drug administration. After that, during the ultrasound, he monitors the dynamics of the dominant follicle and the process of release of the egg from it.
If during the study it is determined that DF can develop independently, then the injection of hCG is introduced only to stimulate its rupture in order to release an egg cell ready for fertilization.
When can I do a pregnancy test?
According to medical research, ovulation after stimulation may occur 12-48 hours after the injection. So, according to reviews of women who resorted to using such stimulation, the injection of hCG at a dosage of 5,000 leaves 7-10 days. And if the dose is suitable for the patient, then during this time the strip on the test will only become brighter.
In addition, you can check when ovulation can occur by analyzing the blood on the growth dynamics of the hormones responsible for ovulatory processes.
Day of testing depends on the duration of the menstrual cycle. With a regular cycle of 28 days, testing should begin to be carried out 19-17 days before the new cycle.
And at the end of this publication I would like to say the following: the stimulation of ovulation with the help of hCG injections is possible only according to indications. There are no exceptions to this rule. Any independent attempts to stimulate the organs of the reproductive system can not only help in solving this issue, but also have a negative impact on the reproductive function. Be attentive to your health and take care of yourself!
What is a hormone?
Chorionic gonadotropin (hCG) is a specific human hormone that contains such subunits as alpha and beta. The second has no analogues in the body, so on its basis tests are done for pregnancy. It is produced in the first weeks of embryo development. Its number increases significantly. However, from the 11th week the concentration of the hormone may decrease.
During this period, it is imperative to follow the features of the course of pregnancy. Jumps in the level of hCG can speak about the pathologies of fetal development, the threat of miscarriage. If the amount of hormone is insufficient, then the woman aborts the pregnancy or its occurrence becomes impossible.
HCG contributes to the production of progesterone and estrogen. The formation of the corpus luteum, the proper development and attachment of the embryo to the uterine mucosa depends on these hormones. It is he who ensures the preservation of pregnancy before the formation of the placenta.
Indications and contraindications to the use of funds
The hCG preparations have a lutenizing gonadotropic effect. They stimulate the onset of ovulation in women. They should be used if the patient is present:
- dysfunction of the gonads, triggered by the malfunction of the pituitary and hypothalamus,
- anovulatory infertility (i.e., lack of formation of a dominant follicle and egg development),
- insufficient functionality of the corpus luteum,
- habitual miscarriage,
HCG injections are required for the normal formation of the placenta in a pregnant woman. Without preparations based on gonadotropins, it is impossible to stimulate ovulation and IVF.
But to apply the drug on the basis of hCG is not always possible. Contraindications include:
- hypersensitivity to the components of the tool,
- early menopause
- congenital or postoperative absence of the gonads,
- pituitary neoplasm,
- hormone-active tumors.
Neither should hCG injections be given in the presence of thrombophlebitis, hypothyroidism, adrenal insufficiency, obstruction of the fallopian tubes, ovarian cancer, and during breastfeeding. Very carefully, you need to use the medicine for kidney failure, bronchial asthma, migraine, pressure jumps, ischemia of the heart, as well as in adolescence.
Rules of application
Before you begin the procedure for introducing hCG, you must make sure that it is allowed. It is important to follow these rules:
- Check the degree of patency of the fallopian tubes. If there is a problem, then it makes no sense to carry out the procedure. You can determine the patency using laparoscopy or other diagnostic methods.
- Determine the balance of hormonal levels. Analyzes are taken on the 3rd day of the menstrual cycle. Based on the results, dosage of stimulant drugs can be selected.
- To conduct an ultrasound. This procedure will have to be carried out many times. It is necessary to determine the ovarian reserve of women.
- Make spermogram partner, as well as test the compatibility of the pair to conceive a child.
HCG Injection 5000 units most often used if a woman for some reason does not ovulate. In most cases, this dose is enough to start the process. It should be done intramuscularly. A woman can make an injection herself if she knows how to do it. If this is not possible, then it is better to entrust the procedure to a specialist.
If the injection of hCG should help stimulate ovulation, then it should be done in the stomach. This method is faster and more convenient. In addition, a shot in the buttock is characterized by the fact that its pain is more pronounced.
The distance from the navel to the injection site is about 2 cm to the left and right side. Next, you need to zaschipt fold of skin and completely to the ground to insert a needle into it. It should be short (preferably insulin). The injection site of hCG must be disinfected.
In the case of stimulation of ovulation without control using ultrasound is indispensable. It is important to monitor the size of the dominant follicle. As soon as they are as acceptable as possible, an HCG injection is immediately given. It is he who starts the process of ovulation. Follicle regression is prevented, so cyst development is prevented.
To stimulate ovulation, a single injection is enough. The effectiveness of the procedure is checked by ultrasound on the second or third day. It greatly increases the chance of getting pregnant.
Before stimulation, you need to check the hormones of a woman. Sometimes it is enough for her to restore the menstrual cycle to undergo a simple course of treatment without the use of hCG.
Features of the stimulation process
Any intervention in the natural processes of the female body, does not pass without a trace. All hormone procedures must be carried out with the permission and under the supervision of doctors. Before you assign an injection of HCG, the specialist must find out the following data:
- the growth dynamics of the follicle,
- endometrial growth features.
And he must predict when ovulation should occur. In addition to the patient's injection, concomitant medications may be prescribed: Puregon or Klostilbegit. After injection, ovulation occurs no later than 36 hours. The following drugs are suitable for injection: Pregnil, chorionic gonadotropin. Dosage means prescribed by a doctor. The most commonly used injection of hCG is 10,000 units.
During this period, you must regularly have sexual intercourse with your partner in order to become pregnant. Sex should be engaged in a day. Further, there is an additional stimulation of the functionality of the corpus luteum, which at first ensures the success of the onset of pregnancy and embryo development.
How to choose the right dosage?
This question should be addressed to the doctor who has the patient's data and is familiar with the instructions for use. Do not use the injection yourself. The first time is usually assigned to 5,000 units of hCG. If this dosage did not give a positive effect, then it can be increased to 10,000 units, but in the next cycle.
If ovulation has occurred, which was confirmed by an ultrasound study, the patient is shown additional stimulation of the functionality of the corpus luteum. The hCG injection is prescribed on the 3rd, 6th and 9th day after the egg is released. The dosage in this case is minimal - not more than 5000 units.
In the presence of recurrent miscarriage, treatment with hCG is long - up to 14 weeks. The first dose of the drug is 10,000 units. Further, the rate is reduced. A woman is given 2 shots a week for 5000 units.
Overdose and special instructions for using hCG
Overdose of hCG may be accompanied by ovarian hyperstimulation syndrome, which adversely affects the overall health of the woman. That is, the patient produces an excessive number of follicles, which eventually degenerate into cysts. Treatment of all side effects is symptomatic.
It is important to remember that long-term use of drugs based on hCG is fraught with the formation of antibodies to them. The likelihood of multiple embryos increases (development of multiple pregnancy). During treatment, as well as during the week after its completion, pregnancy tests may show an erroneous result.
If there have already been several unsuccessful attempts at stimulation in which the dosage of the drugs used was gradually increased, then it is necessary to stop the process and undergo additional tests. After that, therapies are reviewed.
If Klostilbegit is used for stimulation, then it is recommended to use it no more than 5-6 times in a lifetime. Otherwise, ovarian depletion syndrome will occur and the woman will not be able to use her own eggs even for artificial insemination.
If the stimulation did not give the expected result and the pregnancy did not come, do not give up. Perhaps the long-awaited conception will come after 2-3 months in a natural way. Moreover, now there are new reproductive technologies that allow a woman to become a mother.
What is this protocol?
Human chorionic gonadotropin is a specific hormone that is produced in the female body in the first weeks after pregnancy. It contributes to the preservation of pregnancy and prepares the endometrium to secure a fertilized egg. Other function of hCG - stimulating the production of sex hormones progesterone and estradiolwhich in turn provide timely and complete ovulation.
The ovulation stimulation protocol with an hCG injection is an individually developed scheme for administering a hormonal drug with constant monitoring of the ovarian state and control of likely side effects.
The main goal of introducing chorionic gonadotropin is to form full-fledged oocytes in the female body ready for fertilization. It acts directly on the ovaries, contributing to the natural maturation of the egg, its exit from the follicle and the advancement into the fallopian tube. Under the control of ultrasound, it is possible to accurately draw a picture of this physiological process and calculate the most favorable time for conception.
When should such an injection be given?
Injections of chorionic gonadotropin are carried out in the presence of the following indications:
- anovulatory infertility - the absence of the formation of eggs in the female body,
- hormonal dysfunction that is not amenable to treatment by other methods
- violation of the luteal phase of the menstrual cycle, which prevents full ovulation,
- the need to stimulate the follicles of several eggs at once,
presence in the female history of three or more miscarriages,
- the threat of spontaneous abortion,
- preparation for in vitro fertilization,
- high or low body mass index
- infertility of unknown etiology.
Preliminary examinations and analyzes
Injection of gonadotropin is preceded by a whole series of studies - both laboratory and instrumental. They help to identify contraindications to the procedure and to study the individual characteristics of the patient. It is imperative to consult a general practitioner.who comprehensively assess the health status of women. Instrumental studies:
- Ultrasound of the pelvic organs,
- hysteroscopy to confirm tubal patency,
- study of sex hormones and thyroid hormones,
- HIV antibody tests
- Wasserman (RW) reaction to the detection of syphilis,
- bakposevy for candidiasis and trichomoniasis,
- examination of cervical smears for purity and atypical cells,
- studies on TORCH infection (rubella, cytomegalovirus, chlamydia, toxoplasma).
After all the tests, the patient takes a blood test to study the ovarian reserve. This study allows you to assess the chances of a positive outcome of stimulation and to choose the optimal scheme for the introduction of the hormone. In addition to assessing the ovarian reserve, the scheme should take into account the body weight of the woman. and the effect of previous stimulations, if any.
Dosage 5,000 and 10,000 IU
Injections of human chorionic gonadotropin are prescribed in various dosages according to indications, but such doses are most often used:
- 5000 IU - prescribed to stimulate ovulation in its absence, as well as to stimulate the development of the corpus luteum,
- 10,000 IU – назначают для суперовуляции перед проведением процедуры искусственного оплодотворения.
Дату введения гормона назначают только после проведения УЗИ, на котором отразится доминантный фолликул размером около 2 см. As soon as such education is detected, it will be possible to make an injection.
Step by step procedure
Experts recommend injecting hCG subcutaneously into the abdomen. This procedure is less painful than a shot in the buttock, besides, you can carry out the manipulation yourself. Instructions for the introduction of the drug in the stomach:
- Prepare a syringe with a thin insulin needle (2 mm), powder for injection, a vial of saline, a cotton swab and alcohol.
- Wash your hands thoroughly with soap.
- Take a vial of saline in your hands, shake off a drop of liquid from the vial tip.
- Put your thumb on the indicator line on the nose and break off the tip. In order not to cut yourself, you can use a napkin.
- To make the same actions with an ampoule with a powder.
- Draw saline into the syringe, keeping the vial at an angle.
- Slowly inject saline into the vial of powder, you can shake it slightly so that the powder dissolves faster.
- Without removing the needle from the vial, fill all the contents into a syringe.
- Remove residual air from the syringe with a piston.
- Determine the area of the injection - to do this, retreat from the navel to the left or right by 2 cm.
- To process a zone for an injection on a stomach with the wadded ball moistened in alcohol.
- With one hand grab the fold of skin on the abdomen, and the other to make a puncture needle with a syringe for the entire length. Movements must be sharp and precise.
- Introduce the entire amount of the medication, remove the needle. Place the puncture pin down with a cotton swab until the bleeding stops.
How many hours after the procedure does the egg come out of the follicle?
The effectiveness of the technique depends on several factors:
- root causes of impaired ovulatory function,
- woman's age
- the type of drug used,
- the presence of comorbidities and factors affecting reproductive function.
Studies show that in 75% of cases, provided a well-written protocol for the injection of hCG ensures effective maturation and release of the egg. In other cases, re-stimulation is required for another 2-3 cycles.
After a hormone injection, ovulation occurs within the next 25-36 hours.. In order to confirm this, an ultrasound examination is carried out, in which a mature egg will be visible. If the study reveals that the ripe follicle has not burst, a maintenance injection may be given to resume the ovulatory process.
Where and at what price you can buy chorionic gonadotropin?
Chorionic gonadotropin is a prescription drug. You can buy it at any pharmacy, but only on prescription by a doctor. All preparations for injection containing hCG are available in powder form in ampoules or vials and are sold in a kit with a sterile solvent (saline).
The drug is available in several dosages, while the cost is directly dependent on the concentration of the hormone:
- HCG 500 IU - about 430 rubles per pack,
- HCG 1000 IU - about 700 rubles,
- HCG 1500 IU - 1200 rubles,
- HCG 5000 IU - 2500 rubles.
Each package contains 5 bottles of active substance.
Doctors Tips and Recommendations
Experts-fertility experts do not recommend abusing drugs containing hCG, because hormones can lead to exhaustion and ovarian hyperstimulation. As a result, a large number of follicles are formed, capable of reborn into a tumor, and the eggs become unsuitable for fertilization even by artificial means.
With prolonged use of the hormone, the body produces antibodies to it and becomes immune to the drug. Therefore, if stimulation of ovulation with an hCG injection over several cycles was unsuccessful, treatment is reviewed and additional diagnostics are carried out.
- do not self-medicate and strictly follow the dosage prescribed by the doctor,
- when planning a pregnancy to have sex on an individual schedule drawn up by a doctor,
- The ovulation test can be performed 3 days after the stimulation procedure,
- After the injection of the hormone, the pregnancy test is carried out not earlier than 2 weeks after ovulation,
- If after the procedure there are persistent side effects, you must inform your doctor.
Stimulation of ovulation is not a panacea for infertility. The procedure will give a positive result only when the cause of the absence of ovulation is accurately identified and the probable risks to the patient are assessed.
Injection of hCG during ovulation stimulation: who should do it?
HCG is human chorionic gonadotropin. Without it, it is impossible to endure a child. This indicator indicates the presence of pregnancy. By the way, when a woman does a pregnancy test, what does the second strip show? At elevated levels of hCG, which is mandatory in the presence of pregnancy.
But, unfortunately, the cherished second strip may not appear for some. Therefore, the girl decides to stimulate ovulation, which will lead to the release of the egg and its early fertilization. One method of stimulating pregnancy is the injection of hCG.
The article will discuss this injection and its effect on the female body.
If the follicle does not mature
It often happens that the cause of anovulatory cycles is not only that the follicle does not burst. But the fact that it does not grow to the desired size. Then doctors prescribe drugs that stimulate the growth and maturation of follicles. And only when the dominant follicle grows to the desired size, put an injection of HCG.
The classic scheme is as follows. First, activate the process of maturation of follicles with the help of the drug "Klostilbegit" (clomiphene citrate). It is drunk in pill form from the 5th to the 9th day of the menstrual cycle. And only then a chorionic gonadotropin injection is prescribed. Stimulation of ovulation "Klostilbegitom" is not for everyone. Therefore, often gynecologists choose for this purpose other drugs.
When to do an ovulation test?
Ovulation after the injection of hCG should occur 24-36 hours after injection. Sometimes it happens that the release of the egg at a specified time does not occur or is postponed to a later date.
That is why this process takes place under strict control of ultrasound. After ovulation has occurred after the injection of hCG, the patient is prescribed hormones that help maintain ovarian function.
For example, urozhestan or dufaston.
To learn that ovulation after the injection of hCG has come, a woman can not only by ultrasound, but also a special test.
So, after what time after the injection of human chorionic gonadotropin is best to determine whether the release of the egg from the follicle?
Those who helped to get pregnant with the hCG injection know that successful conception is impossible without strict adherence to all recommendations of the attending physician.
It is a competent specialist who will help to find out whether a woman with an anovulatory cycle really needs to introduce chorionic gonadotropin.
He will answer the question, after how much after an unsuccessful injection, you can try again. When to do a test for ovulation and pregnancy, and more.
In any case, women need to remember:
- chorionic gonadotropin preparations should be prescribed by a doctor after a comprehensive examination of the patient and clarification of all the features of her body,
- you need to strictly observe the terms of entering HCG, make ultrasound in time,
- the technique does not guarantee 100% result,
- not all forms of anovulatory disorders are equally sensitive to treatment with hCG,
- It is necessary to control ovulation using ultrasound, as the test is not a sufficiently informative diagnostic method,
- For successful conception, not only is a full-fledged egg, but also high-quality sperm, so when planning a pregnancy for infertility, both partners should be examined.
Only by observing all the recommendations of gynecologists, you can count on a successful solution to your problem.
HCG injection - instruction. How many after the injection of hCG do ovulation test?
When a woman has problems with conception, the treatment raises many questions and often scares the terminology. What is the injection of HCG, in what cases it is used, how effective it is, what contraindications it has - let's look at it together.
Human chorionic gonadotropin (hCG) - this term refers to a hormone that is produced in the body after fertilization of the egg and is responsible for the preservation and development of the fetus during pregnancy. It is the determination of the level of this hormone that underlies the pregnancy test.
HCG injection: what is it done for and when?
Injections of hCG are used as a drug for the prevention and treatment of female infertility, as well as preservation of the fetus during pregnancy. Injections are made:
- to stimulate the egg and reduce the risk of cyst formation that occurs when the follicle is not torn, but is compressed in size
- to preserve the life of the corpus luteum in early pregnancy
- to maintain the functions of formation and development of the placenta
- at risk of miscarriage - especially if such pathologies have already been repeatedly
- in case of artificial insemination for the effect of "superovulation"
HCG injection for ovulation
Most often, hCG injection is used in the absence of ovulation, i.e. violation of the function of maturation of the egg, capable of fertilization. This condition may be due to various reasons:
- polycystic ovary
- tumor formation
- increased physical activity and overwork
- stressful conditions
- taking certain medications
In the course of diagnosing a violation of ovulatory function, a woman needs to be tested for hormone levels, to regularly record basal temperature, to undergo ultrasound of the pelvic organs.
- Such examinations should determine the need to stimulate ovulation by hCG injection. In some cases, normalization of the hormone levels of the thyroid gland, testosterone and prolactin can naturally restore the ovulation cycle.
- To confirm the absence of ovulation, a constant ultrasound is monitored for the development and growth of follicles. The first study is conducted on the 8-10 day from the date of the onset of the last menstruation, then it is repeated with an interval of 2-3 days before the next one begins.
Hormone testing before hormone therapy
In the process of research can be established:
- The complete absence of ovulatory function due to the malfunctioning of the ovaries - follicles do not mature
- The main follicle matures, but does not develop to the required size
- The follicle develops normally, but there is no disclosing of the follicular sac and the release of the egg
If during the observation it is revealed that the follicle does not break, an injection of hCG can be prescribed to resume ovulation. After 24-36 hours after the injection, an additional ultrasound is prescribed to confirm successful stimulation.
Permanent ultrasound control to track changes during stimulation with hCG injections
After how much after the injection of hCG ovulation occurs
- With the problem identified, the treatment of infertility should be carried out under constant supervision. The first injection is given on the 2nd day of the cycle for 10 days.
- The entire process of maturation of follicles and their growth is controlled by ultrasound. When the size of the follicles is 20–25 mm, they are stimulated to open; for this, an injection of hCG is administered in the required dosage.
- An increase in the level of the hormone occurs during the first days after the injection. Therefore, positive tests for ovulation during the first 3 days can not reliably indicate its occurrence.
- Usually, after hCG injection, ovulation occurs in a period of 24 to 36 hours. In some cases, ovulation may not occur or come much later. The onset of ovulation can be set using ultrasound
- After confirmation of ovulation, hormone injections of progesterone and progesterone are usually given to support ovarian function.
Injections of hCG during pregnancy
Hormonal injections are prescribed to pregnant women if a sharp drop in blood levels of chorionic gonadotropin is diagnosed. Before the appointment of hormone therapy is carried out additional tests on the level of the hormone.
If the deviation from the norm is significant and amounts to 20% downwards, the injection of hCG is prescribed without fail.
A decrease in the level of the hormone may signal the development of the following pathologies of pregnancy:
- suspected ectopic pregnancy
- missed abortion
- violation of vital functions of the placenta
- threat of interruption
Administration of an hCG injection to pregnant women to maintain the functions of the placenta and preserve the fetus
The presence of a high level of the hormone hCG in the absence of pregnancy can be an indicator of the development of a cancer.
It has not yet been established whether the production of a hormone is a consequence of or the cause of cancer, but since 2011, non-licensed homeopathic and food products, the content of hCG, which were advertised as auxiliary drugs for the treatment of infertility, have been banned for sale.
How does the stimulation
Before prescribing a certain method of stimulation, the doctor thoroughly examines the patient and her partner (spermogram, compatibility test), takes tests from them, determines possible contraindications, prescribe prior therapy if necessary, and based on these data selects stimulation schemes, individual dosage of drugs. When to start a course of stimulation and how long it will last depends on the data from the examination of the patient's uterus and ovaries.
The doctor is obliged to monitor the maturation of the egg, in a timely manner to detect the formation of ovarian cysts. To do this, a woman regularly undergoes ultrasound, control progesterone levels, measure basal temperature. If a cyst is detected during diagnosis, treatment is suspended until it is completely resolved. In the next cycle, the stimulation can usually continue.
After stimulation, in vitro fertilization may be prescribed (during IVF protocol).
When stimulation is contraindicated
In the presence of inflammation, infectious diseases, genital infections, hormonal disorders, hepatitis in one or both spouses, obstruction of the fallopian tubes, the presence of male infertility, poor spermograms of the partner, no stimulation of ovulation is indicated. The age of the woman also matters, as well as reception of certain medicines. If defective eggs are recommended to use donor material.
Klostilbegit and injection of hCG to stimulate ovulation
The drug Klostilbegit - the most popular and effective means of stimulating ovulation. Promotes the production of hormones LH, FSH. Together with him, an injection of hCG is often prescribed to prevent the formation of follicular cysts. Therapy is carried out from the 5th to the 9th day of the cycle.
2 days after the start of taking Klostilbegit tablets, the first ultrasound is performed, on the basis of which a conclusion is made about the growth rate of the follicles. The procedure is repeated every 2 or 3 days throughout the course, until the follicles reach at least 20 mm.
To avoid the formation of cysts (empty neovulatory follicles), follicle regression is important to appoint an injection of hCG in time, which activates the process of ovulation after 24-36 hours. This is confirmed by ultrasound. After this, Utrogestan / Progesterone injections are shown to support the corpus luteum (only after the onset of pregnancy).
According to reviews of patients, this scheme leads to conception from the first time on the condition of daily sexual intercourse from the day when the first injection of hCG was indicated.
Proginova as part of a scheme to stimulate ovulation
The above scheme with the use of estrogen depressant Clostilbegit is supplemented with the drug Proginova, which contains the female hormone estrogen. Proginova prescribed to patients from the 5th to the 21st day of the cycle. Proginova normalizes hormones in a woman’s body, prevents early ovarian depletion. Like Klostilbegit Proginova is taken preorally.
Injections to stimulate ovulation
Injections intramuscularly are popular among doctors and their patients. The treatment regimen based on the use of gonadotropins includes injections of human menopausal (Menopur, Pergonal, Menogon) or recombinant gonadotropin (the latter include Gonal F, Puregon). The first is cheaper because it is synthesized from the urine of women in menopause. It contains LH, FSH.
Schemes with its use are appropriate when a mild effect on the ovaries is indicated. Recombinant gonadotropins are produced in the laboratory, they are devoid of impurities and therefore are close in action on the body to natural FSH. The prick of Puregon, Gonal has this effect. Injections of hCG (Ovitrel, Pregnil, Horagon, Prophase) and gonadotropins are produced on an outpatient basis.
The hCG injection may be a sufficient means to stimulate the rupture of the dominant follicle, if the latter develops normally, does not need artificial stimulation, grows to the desired size, but does not rupture itself (follicle regression occurs, cyst formation in the first 7 days of the cycle).
If there is no ovulation for other reasons, one injection of human chorionic gonadotropin is indispensable.
Gonal F to stimulate ovulation
Гонал Ф – самый мощный аптечный препарат для стимуляции овуляции. Гонал Ф содержит ФСГ и входит в группу лекарств на основе гормонов гонадотропинов, ответственных за половые органы. Гонал Ф синтезируется искусственно.
The treatment regimen with Gonal provides for injections (intramuscularly, subcutaneously) in strictly defined doses on the days set by the doctor. Gonal F is a prescription because it is a hormonal drug and has limited indications for use.
If Gonal F was used according to indications, then pregnancy may occur after the first course. Injections of the drug lead to the following results:
- stimulates the growth and differentiation of follicles,
- the cycle is normalized
- ovulation is regulated,
- endometrial growth is stimulated,
- estrogen levels increase,
- hormonal balance is fully restored,
- full ovulation occurs in time, the uterus is well prepared for the adoption of a fertilized egg.
To whom ovulation stimulation helped to get pregnant
Most often, to stimulate ovulation before artificial or natural conception, doctors prescribe clostilbegit or drove F.
It happens that the drugs help the first time, other women are forced to drink pills or to do more than one injection on n-ko cycles in a row.
Success largely depends on the doctor determining the exact reason for the lack of ovulation before treatment and the selection of appropriate drugs and doses. For each woman, the treatment results are individual.
The stimulation scheme of the drug Closibelgit costs about 400-700 rubles (300 UAH.) + The cost of regular ultrasound. An injection of the drug chased F (75 IU) will cost from 1150 rubles. on average (640 UAH. in Ukraine). 300 IU pack
4,000 rubles, 900 IU - more than 17,000 rubles.
An injection of human chorionic gonadotropin is much cheaper - between 700 and 1300 rubles. for 10 pcs. 1000 Units and 5 pcs. 5000 units respectively. Injections can be saved if you do them yourself, following the instructions. Proginova in pharmacies of the Russian Federation is 165-200 rubles.
Of course, the cost of IVF is the highest (about 100 thousand rubles in the Russian Federation, from $ 3-4 thousand to € 3-4 thousand and more abroad). Sometimes stimulation with clostilbegit is combined with gonadotropin injections and the addition of the Menopur cycle on certain days (
14000 rub. packaging). The cost of treatment is reduced due to the fact that the injections with this technique will require much less than with conventional treatment with gonadotropins.